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Cause

Eczema has a genetic basis and tends to run in families. It is often associated with other conditions such as asthma or hayfever. Children with eczema have dry, sensitive skin which is easily irritated by certain chemicals (such as soaps or bubble-bath solution) and by contact with woollen or polyester garments. In some children diet seems to play a role in eczema, although it is often very difficult to find the offending food. Eczema is not contagious.

Clinical features

Eczema is a common condition in childhood. It is characterised by a very itchy, red rash, usually present in patches on the elbow creases and behind the knees, although it may occur on the face, neck, hands and feet. The rash may develop cracks and weep or bleed, especially when the child scratches excessively because of the itch. This may cause a problem with infection by bacteria which enter the skin via the cracks. In between attacks of eczema, the skin looks thickened and dry (lichenification).

Eczema usually begins at some time during the child’s infancy, often in the first few months of life, and may be present initially only on the face and scalp, or in the nappy region. Most children tend to ‘grow out of eczema by adolescence, but in some it will persist throughout adult life, usually flaring up at times of stress or after contact with irritating chemicals or other substances.

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